ACCIDENT
INVESTIGATION
Objectives of Training
Describe the purpose and objectives of
accident reporting
List and use the proper accident
investigation steps
Preserve evidence
Select and interview accident witnesses
Fill out an accident report
Purpose of
Accident Investigation
 Accident investigation is an essential step towards
making changes that can prevent recurrence of accidents
from similar causes.
 If anything positive results from an accident, it is the
opportunity to determine the causes and how to
eliminate these causes.
 Thorough accident investigation can identify hazardous
activities and conditions within an organization.
Purpose of
Accident Investigation
 By definition, this knowledge is gained after, rather than
before, the occurrence of an accident.
 Accident investigation involves more than merely filling
out forms. Well-managed organizations insist on quality
accident investigations, just as they insist on efficient,
quality production.
Accident Reporting
A good accident investigation program is based on
an effective, thorough accident notification plan.
Many organizations make the mistake of requiring
notification and investigation of only “serious”
accidents.
When the causes are removed, accidents can be
prevented.
Accident Reporting
All incidents must be reported as soon as possible whether they did or could have resulted in personal
injuries, illnesses, or property damage.
For example, a tool falling off a platform that is missing toe
boards might not hurt anyone. However, it just as easily could
have fallen on someone’s head, inflicting a serious injury.
Regardless of the outcome, this kind of incident should be
reported, the cause investigated, and corrective action taken to
prevent recurrence.
To help establish an effective accident reporting system,
make sure the subject is covered in the new employee
orientation program.
Finding Causes
The purpose of accident investigation is to determine
causes and recommend corrective actions to eliminate or
control these hazards.
Accident investigation should be aimed at fact-finding
rather than fault-finding; otherwise, the investigation
can do more harm than good.
 The emphasis should be on identifying all possible causes, not
on who could be blamed for the accident.
 An attempt to place blame damages the investigator’s
credibility and generally reduces the amount and accuracy of
information received from workers.
Finding Causes
This does not mean oversights or mistakes should be
ignored, nor that personal responsibility should not be
determined, when appropriate.
It means that the investigation should be concerned only
with the facts.
To do a quality job of investigating accidents, the
investigator must be objective and analytical.
Multiple Causation
A report must do more than just identify unsafe acts or
hazardous conditions surrounding an incident.
These may be only contributing causes but not the root
causes of a specific accident.
For example, an accident report might state that the incident
was caused by an oily patch on the floor.
Instead of merely noting there was oil on the floor, the supervisor
must determine how and why the oil got there.
If there was an equipment lubrication leak, had the condition been
previously reported?
If poor maintenance was the cause, had that been reported? If so,
when?
If not, why not?
Multiple Causation
These are the kinds of questions that must be asked and
answered (i.e., who, what, where, when, how, and why).
Generally, the procedures followed during an investigation
are designed to elicit clues to other problems. Inadequate
maintenance, poorly designed equipment, untrained
employees, and lack of policy enforcement or standard
procedures (management control) are all causative factors
This diagram shows a basic system in which people,
equipment, and the environment are managed to
accomplish a mission. Sometimes they work together in
unplanned ways to produce accidents.
PEOPLE
MISSION
EQUIPMENT
ENVIRONMENT
Steps in the Investigation
TAKING IMMEDIATE ACTION
The safety and health of employees and visitors must be
the primary concern when an accident occurs.
If an injury or illness results, make sure the affected persons get
immediate medical attention and take steps to provide for
emergency rescue or evacuation, as necessary.
In addition, take any actions that will prevent or minimize the
probability of further accidents happening as a result of the initial
accident.
Securing the Accident Site
After rescue and damage control are completed, the
accident site must be secured for the duration of the
investigation.
It is essential to barricade or isolate the scene with
ropes, barrier tapes, cones, and/or flashing lights to warn
people or otherwise restrict access to the area.
In extreme cases, guards may be posted to make sure
no unauthorized persons enter the scene.
Securing the Accident Site
Nothing should be removed from the site without
approval of the person in charge of the investigation.
The site should be maintained, as much as possible, just
as it was at the time of the accident to help investigators
identify and examine evidence
Preserving Evidence
Time is critical when investigating accidents.
The faster the investigator gets to the accident scene, the
less chance there is that details will be lost.
A prompt and careful investigation will help to answer
the questions of who, what, where, when, how, and why.
 For example, witnesses will remember more facts, chemical spills
will not have had time to evaporate, and dust and debris will
remain as it was.
Preserving Evidence
Preserving evidence at the accident scene ultimately
makes the investigative process much less frustrating.
Observing and recording evidence - such as instrument
readings, control panel settings, and details of weather
and other environmental conditions - can greatly improve
investigation results.
Evidence can be preserved on film, recorded on tape,
diagramed, or sketched.
Detailed notes must accompany any pictures or drawings.
Recording Visual Evidence
Visual evidence should be recorded by using cameras,
video cameras, drawings, and notes.
The digital camera is one of the most valuable tools for studying
accidents.
A point and shoot camera is often preferred by those with no
photographic experience.
Photographs can be studied in detail and at length to look for things
initially overlooked.
General and specific scenes should be photographed in
order to make comprehensive visual records.
No one can predict in advance which data will be most
useful, so take photographs from many different angles.
An old saying for accident photographers is “overshoot and underprint.”
This means take every possible photo that might be needed, and make
necessary enlargements after the proofs have been studied.
Recording Visual Evidence
In addition, accurate, complete, and annotated
sketches and diagrams of the accident scene should be
made.
Photographs of objects involved in the accident should
be identified and measured to show the proper scale
and perspective.
A ruler or coin can be placed next to objects
photographed close up to demonstrate the object’s size.
Accurate measurements of the area, equipment, and
materials involved can be vital to accident
investigations, with or without photographs.
Effective Use of Witnesses
IDENTIFYING WITNESSES
Avoid restricting the search for witnesses to those who saw
the accident happen.
Anyone who heard or knows something about the event may
offer useful information.
Ask witnesses to identify and document the names of others
who were in the area, so that everyone can be contacted.
Effective Use of Witnesses
INTERVIEWING PROCESS
Witnesses should be interviewed one at a time in privacy, as
soon after the accident as possible.
The accuracy of people’s recall is highest immediately
following an event.
A prompt interview minimizes the possibility of a witness
subconsciously adjusting his or her story.
If too much time elapses, many things can cloud a person’s
memory.
For example, hearing other opinions or reading stories about
the accident can influence a witness.
A person with a vivid imagination can “remember”
situations that did not actually occur.
Make sure to set aside time at the beginning of the
investigation to interview as many witnesses as you can.
Effective Use of Witnesses
Whenever possible, interviews should be conducted at the
accident site.
This gives witnesses an opportunity to describe and point out
what happened.
Also, being at the scene can spark a person’s memory.
Tactful, skilled investigation will usually elicit greater
cooperation from employees.
Remind witnesses that you are interested in the facts of the
accident, not in placing blame.
Such reassurance can dispel people’s fear that they may
incriminate themselves or others.
Effective Use of Witnesses
HOW TO INTERVIEW
When conducting a witness interview, establish a
relaxed atmosphere.
Be a good listener.
Witnesses should be allowed to tell their stories without interruption or
prompting.
More detail can be sought after the full story has been told.
Interruptions can derail a person’s train of thought, influence answers,
and inhibit responses.
To elicit the most information, open-ended questions without leading
words are best.
For example, asking “Where was he standing?” is preferable to “Was he standing there?”
Remember that the purpose is to determine the facts of the accident and
to gain as much information from witnesses as possible.
Questions should cover the specifics of who, what, where, when, how,
and why.
Effective Use of Witnesses
HOW TO INTERVIEW
Take notes and record employee statements, as
unobtrusively as possible, for later review.
In some cases, it may be best to wait until the employee has
finished explaining what happened before making notes or
recording details.
If the employee’s statement is recorded, get his or her
permission and have it typed for the employee’s review,
corrections, and signature.
After the witness is through, always repeat the information as it
is understood.
This feedback technique reduces misunderstandings and often
leads to further clarifications.
Effective Use of Witnesses
HOW TO INTERVIEW
Employees who have been directly involved with the
accident should be contacted first, followed by
eyewitnesses, and those who were nearby.
Always use discretion in situations where employees have
been injured.
Fellow workers might be in shock, unable to speak
coherently, or have no memory of the accident.
Sometimes it is better to postpone interviews until the
employee or a witness who has been involved is in a more
stable physical or emotional condition.
A part of the emergency should include care for traumatized
co-workers.
Effective Use of Witnesses
HOW TO INTERVIEW
It is helpful to solicit ideas from the interviewed
employees regarding ways to prevent a recurrence of
the accident.
Often they will have the best suggestions.
This will also help them to feel involved in the investigation
and provide an opportunity to recognize their willingness to
participate.
Be sure to record these as suggestions made before causes
have been determined.
The interviews should end on a positive note.
Thank each individual for his or her time, information
supplied, and ideas offered.
Reenacting the Accident
In some cases, reenacting an accident can provide valuable
information about how and why it occurred.
Expert investigators have learned to use this technique
with caution, however, so the reenactment doesn’t cause
another accident!
Before asking people to reenact the scene, follow these
steps:
Ask employees to explain what happened first.
This preliminary explanation should give additional
insight about the accident.
Reenacting the Accident
The investigator may want to ask employees to show
“what they mean or how it happened.”
Make sure that the witnesses thoroughly understand that
they are to go through only the general motions of the
event under close supervision.
They should not repeat the exact actions that produced the
original event.
Selecting a Location
When it is not possible to interview people at the accident
site, choose another location free from distractions and
away from other witnesses.
Privacy is essential.
When people are discussing what they saw take place, they
can influence other witnesses.
You may want to avoid having people revise their stories.
Do not pressure or influence witnesses.
If possible, do not use your office to conduct interviews;
employees may find the supervisor’s office intimidating,
inhibiting, or distracting.
Accident Investigation
Reports
The purpose of accident reporting is to alert and
inform management and other concerned people
about the circumstances surrounding an accident.
The report should record in clear, concise language
all appropriate facts of the accident.
Write down all causal factors that might have led to the
event.
These factors will be assigned to one or more of the
following causal categories:
equipment, environment, personnel, and management.
Accident Investigation
Reports
Here are some typical questions to help you identify the
accident causes:
Was there a procedure in place to detect the hazardous condition?
Was the correct equipment, material, or tool readily available and
in safe condition?
If so, was it used according to established procedure?
Responsibility for carrying out recommended corrective
actions and a timetable for their completion should be
established.
Completion reports should be required as a means for
assuring the recommended actions have been carried out.
Filling Out a Report
An accident report is designed primarily for investigation of
accidents involving injuries.
 However, it also can be used to investigate occupational illnesses
arising from a single exposure (for example, dermatitis caused by
splashed solvent or a respiratory condition caused by the release of
a toxic gas).
All questions on this form should be answered.
If no answer is available, or the question does not apply, the
investigator should indicate this on the form.
Filling Out a Report
Answers should be complete and specific.
Supplementary sheets can be used for other information,
such as drawings and sketches, and should be attached to
the report.
A separate form should be completed for each employee
who is injured in a multiple-injury accident.
Filling Out a Report
Exhibit #1
Filling Out A Report
Exhibit #2
Filling Out A Report
Exhibit #3
Filling Out A Report
Exhibit #4
Summation
Key points covered in this chapter include:
 The purpose of accident investigation is to determine causes and
recommend corrective actions to eliminate or control hazards and
prevent recurrence of accidents.
 All incidents should be investigated, not only those that cause serious injury
or property damage.
 The investigation should emphasize fact finding, not finding fault.
 An organization should set up a plan for responding to accidents.
 The plan should specify what should be done in case of an accident, list
names and phone numbers of people to call, and assign specific
responsibilities to all persons involved in the Emergency Response Plan.
 When an accident occurs, supervisors should first see that injured
persons get immediate medical attention, then secure the accident
site for the investigation duration.
 Evidence can be preserved on film, recorded on tape, diagrammed, or
sketched.
Summation
 Witnesses are often the best source of information about an
accident.
 Supervisors should speak with anyone who was in the accident area, not
only with those who actually witnessed the event.
 Witnesses should be interviewed one at a time as soon after the
accident as possible to ensure accurate recall.
 The supervisor may ask witnesses to reenact, with appropriate safeguards,
how an accident happened.
 Interviews should be conducted in a sensitive manner and in a comfortable
location to avoid intimidating witnesses or influencing their stories.
 Accident reports are designed to inform management and other
concerned people about the circumstances surrounding an accident.
 Causal factors leading to an accident generally fall into one or more of the
following categories:
 equipment, environment, personnel, and management.
 These reports must be filled out as completely and thoroughly as possible.